Healthcare Provider Details

I. General information

NPI: 1215415989
Provider Name (Legal Business Name): KIMBERLY DENISSE GARCIA IRIZARRY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4972 TOWN CENTER PKWY
JACKSONVILLE FL
32246-8595
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 904-642-6100
  • Fax: 904-642-5154
Mailing address:
  • Phone: 954-967-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME174425
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: